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Historically, doctors’ practices have been relatively small, and owned by doctors themselves. Hospitals and insurance companies have also bought out many independent physicians’ practices. Optum, an arm of the publicly traded UnitedHealth Group, which also owns one of the nation’s largest insurers, employs roughly 70,000 physicians. Private equity is often viewed by physicians as an attractive alternative to having their practice bought by a hospital. “It can be a really good thing, but the private equity firms have to keep their promises and be held accountable,” she said.

Persons: ’, “, ”, Richard Scheffler, Lisa Walkush, Grant Thornton, Michael Kroin Organizations: Physicians, Institute, Petris, . Hospitals, UnitedHealth Group, Growth Partners Locations: U.S, Berkeley, Chicago

Mr. Biden has authorized the shipment of cluster munitions, controversial within the alliance, to fill the gap until more shells can be produced for Ukrainian artillery — and, though it was left unsaid, to better be able to destroy Russians in their deeply dug trenches. The concern is that the munitions create a post-conflict hazard much like land mines. “Duds” that are scattered around the battlefield can explode years later, often when children pick them up. Mr. Sullivan noted on Friday that signatories to the treaty cannot ship them to Ukraine or help the United States in doing so, but he said that they did not vocally oppose Mr. Biden’s decision. In fact, Mr. Biden has received more criticism from some members of his own party than from the members of the treaty.

Persons: Vladimir V, Putin, Mr, Biden, Jake Sullivan, Biden’s, Germany —, Sullivan Organizations: NATO, Cluster Munitions Locations: Moscow, Russia, Britain, France, Germany, United States, Ukraine

Now, Mr. Biden’s aides think they have little choice. Ukraine, which has deployed cluster munitions of its own in the war, is burning through the available supply of conventional artillery shells, and it will take time to ramp up production. One American official said Thursday that it was now clear that the weapons are “100 percent necessary” to meet the current battlefield needs. The administration has also been aware that sending the weapons to Ukraine would be enormously unpopular among allies and members of Mr. Biden’s own party; over the years, many Democrats have led the charge to bar the use of the weapons by American troops. When, five days into the war, Jen Psaki, then the White House press secretary, was asked about the Russian use of unconventional weapons, including cluster munitions, she said: “We have seen the reports.

Persons: Biden, Volodymyr Zelensky, Biden’s, Jen Psaki Organizations: American, White House Locations: Ukraine, United States, Russia

☆ Biden and Putin Have Dueling Messages on the Mutiny in Russia
▼ + stars: | 2023-06-26 | by ( David E. Sanger | ) www.nytimes.com time to read: +1 min

“We were not involved,” Mr. Biden insisted. But the lead item on the agenda is how to word political promises to Ukraine about how, and perhaps when, it might expect to join NATO. It was just such a drifting to the West, and toward the alliance, that contributed to Mr. Putin’s drive to invade the country last year. Since the start of the war in Ukraine, anticipating and undermining Russian information operations has been a key element of Mr. Biden’s strategy. That was why the president, over the objection of many in the intelligence agencies, decided to rapidly declassify intelligence in the fall of 2021 that Mr. Putin was planning to invade Ukraine.

Persons: ” Mr, Biden, “, Lithuania —, Putin Organizations: United States, NATO, Mr, Russian Locations: United, Vilnius, Lithuania, Belarus, Soviet Union, Ukraine, Bucha

☆ U.S. Suspected Prigozhin Was Preparing to Take Military Action Against Russia
▼ + stars: | 2023-06-24 | by ( David E. Sanger | Julian E. Barnes | ) www.nytimes.com time to read: +1 min

Senior American national security officials had indications as early as Wednesday that Yevgeny Prigozhin, the leader of the Wagner Group, was preparing to take military action against senior Russian defense officials, according to officials briefed on the intelligence. The information suggests that the United States had at least some warning of impending chaos in Russia, just as it warned in late 2021 that Vladimir V. Putin was planning to invade Ukraine. In this case, the information was considered both solid and alarming because of the possibility that a major nuclear-armed rival of the United States could descend into chaos. While it is not clear exactly when the United States first learned of the plot, intelligence officials conducted briefings on Wednesday with the administration and defense officials. By Friday night, Prigozhin had dramatically escalated his feud, launching a march on Moscow that the Russian government described as an attempted coup.

Persons: Yevgeny Prigozhin, Vladimir V, Putin, Prigozhin Organizations: American, Wagner, United Locations: United States, Russia, Ukraine, Moscow, Belarus

☆ Allies Pressure Biden to Hasten NATO Membership for Ukraine
▼ + stars: | 2023-06-14 | by ( David E. Sanger | Steven Erlanger | ) www.nytimes.com time to read: +1 min

Krisjanis Karins, the American-born prime minister of Latvia, argued that “the only chance for peace in Europe is when Ukraine will be in NATO.” Speaking Wednesday at a strategy conference in Riga, he said that any other outcome means inevitably “Russia will come back.”The hope in the push is that once Ukraine is a full member of the alliance, Russia would not dare to try to topple the government in Kyiv because an attack on one NATO country is considered an attack on them all. Ukrainian membership has become a “consuming debate,” both in Europe and inside the Biden administration, according to one senior U.S. official who is deeply involved in the discussions. Only Germany has sided fully with Mr. Biden, though some of the other 29 allies have their own quiet doubts about Ukraine’s readiness to fully join the alliance — and the risks that NATO nations could get sucked directly into a conflict with Russia in the future. In a blur of memos and meetings, several American officials, led by Secretary of State Antony J. Blinken, appear to have taken the position that the Biden administration will be forced to be more specific about Ukraine’s path to membership, even if no date can be agreed upon in the middle of a war that has no clear end in sight.

Persons: Krisjanis Karins, ”, Biden, Antony J Organizations: NATO, U.S Locations: American, Latvia, Europe, Ukraine, Riga, Russia, Kyiv, Germany

daily record (2003) 35: E.P.A.’s safe daily levels 377: Wednesday in New York City Source: New York City Community Air Survey and New York State Department of Environmental Conservation Data shows hourly concentrations of PM2.5 particles, measured in micrograms per cubic meter, for seven N.Y.C. The air in New York City on Wednesday wasn’t just bad by the city’s standards. It was historically bad, even compared with places around the world that generally experience much more air pollution. Wednesday’s daily average was the highest since recording in New York began in 1999. Wednesday’s pollution, of course, was not caused by a power plant or vehicles, but by major wildfires in Canada, mostly in Quebec.

Persons: San Francisco —, Eric James, James Organizations: New York City, New York City Community Air Survey, New York State Department of Environmental, Records, Protection Agency, state’s Department of Environmental, Environmental Protection Agency, University of Colorado, National Oceanic, Atmospheric Administration, Administration Locations: New York, Portland ,, San Francisco, New York City, Canada, Northern California, Quebec, North America

☆ U.S. Will Try to Bring China Into Arms Control Talks
▼ + stars: | 2023-06-02 | by ( Julian E. Barnes | David E. Sanger | ) www.nytimes.com time to read: +1 min

The White House will renew its effort to draw China into discussions about entering arms control talks, President Biden’s national security adviser said on Friday, and will attempt to establish a global accord that specifies that artificial intelligence programs can never be used to authorize the use of nuclear weapons without a human in the decision loop. The speech by Jake Sullivan, the adviser, was the first to describe with some specificity Mr. Biden’s plans to deal with a world in which, he said, “cracks in our post-Cold War nuclear foundation are substantial.” But the solutions he pointed to were largely aimed at maintaining nuclear deterrence by supplementing America’s deployed arsenal of 1,550 weapons with new technologies — from precision-strike conventional weapons to technological updates of the existing nuclear complex — rather than entering renewed arms races. For the first time, Mr. Sullivan was explicit on the American response to China’s rapid military buildup, which the Pentagon says could lead it to deploy up to 1,500 nuclear weapons by 2035, a fivefold increase from the “minimum deterrent” it has possessed for nearly 60 years. If Beijing hits that number, America’s two biggest nuclear adversaries would have a combined force of over 3,000 strategic weapons, which can reach the United States. But Mr. Sullivan argued that the U.S. arsenal does not need to “outnumber the combined total of our competitors” to remain an effective deterrent.

Persons: Jake Sullivan, Biden’s, Sullivan Organizations: Pentagon Locations: China, Beijing, United States

☆ The Big Part of the Debt Ceiling Deal Congress Isn’t Talking About
▼ + stars: | 2023-05-31 | by ( Margot Sanger-Katz | Alicia Parlapiano | ) www.nytimes.com time to read: +10 min

Annual deficit projections $3 trillion Current trajectory Full debt limit deal Debt limit bill House G.O.P. bill passed in April $2 trillion $1 trillion 2023 2028 2033 Annual deficit projections $3 trillion $2 trillion $1 trillion Current trajectory Full debt limit deal Debt limit bill House G.O.P. But negotiators are confident enough in the agreement that they are moving forward with the debt limit bill this week. The debt limit deal scenarios assume that after budget caps lift in 2026, Congress will increase spending in line with inflation. It's also possible that the entire deal holds, and the next Congress will still make vastly different spending choices.

Persons: Kevin McCarthy, Biden, “, It's Organizations: House Republicans, White, New York Times, Congressional, Republicans, Office, SNAP, Internal Revenue Service, Social Security, Medicare, Savings, Energy, Biden, Medicaid, of Commerce, Federal Locations: That’s, G.O.P, Washington

☆ Biden Sees Coming ‘Thaw’ With China, Even as He Rallies Allies Against Beijing
▼ + stars: | 2023-05-22 | by ( Peter Baker | David E. Sanger | ) www.nytimes.com time to read: +1 min

President Biden and his allies spent much of the G7 summit in Hiroshima, Japan, announcing new arms packages for Ukraine, including a pathway to providing F-16 fighter planes. They spent hours discussing strategy with President Volodymyr Zelensky for the next phase of a hot war started by Russia. It is far too early to say whether the president’s optimism is based on the quiet signals he has received in behind-the-scenes meetings with the Chinese government in recent weeks. Mr. Biden’s own aides see a struggle underway in China between factions that want to restart the economic relationship with the United States and a far more powerful group that aligns with President Xi Jinping’s emphasis on national security over economic growth. As this weekend showed, China is enormously sensitive to any suggestion that the West is organizing a challenge to Beijing’s growing influence and power.

Mr. Zelensky, American and British officials say, seems to sense that when he shows up in person, he can both break through American resistance to sending more powerful weapons and pressure nations like India and Brazil that have stayed on the sidelines. Even before he arrived, Mr. Zelensky had won a significant victory. Mr. Biden met with the other leaders of the so-called Quad — Australia, India and Japan — on Saturday night. Mr. Zelensky will also meet with Prime Minister Fumio Kishida of Japan on Sunday, the Kyodo News agency reported. The G7 leaders have already pledged at the summit to toughen punishments on Moscow and redouble efforts to choke off funding for its war.

HIROSHIMA, Japan — President Biden and other leaders of the world’s major industrial democracies rallied around Ukraine on Sunday with vows of resolute support and promises of further weapons shipments even as Russian forces claimed to have seized full control of a bitterly contested city. Mr. Biden and his counterparts figuratively and, in some cases, literally wrapped their arms around President Volodomyr Zelensky of Ukraine, who made an audacious journey halfway around the world from his ravaged homeland to Hiroshima, Japan, to solicit aid for the first time in person from the Group of 7 powers at their annual summit. “Together with the entire G7, we have Ukraine’s back, and I promise we’re not going anywhere,” Mr. Biden told Mr. Zelensky while announcing another $375 million in artillery, ammunition and other arms for Ukraine. At a later news conference, Mr. Biden voiced defiance of President Vladimir V. Putin of Russia. “I once more shared and assured President Zelensky, together with all G7 members and our allies and partners around the world, that we will not waver,” he said.

☆ After a Show-Stopping Entrance at the G7, Zelensky Pleads for More Aid
▼ + stars: | 2023-05-20 | by ( David E. Sanger | Peter Baker | ) www.nytimes.com time to read: +1 min

President Volodymyr Zelensky of Ukraine landed in Japan on Saturday determined to urge the wealthiest democracies in the world to stick with him as Moscow bets on the West growing fatigued by the cost and consequences of the war. He was dressed in his signature hoodie, standing out from the coat-and-tie diplomatic crowd of this annual summit meeting. Mr. Zelensky, American and British officials say, seems to sense that when he shows up in person, he can both break through American resistance to sending more powerful weapons and pressure nations like India and Brazil that have stayed on the sidelines. His presence could make it more difficult for them to maintain their stance as fence sitters, several officials said. And even as Mr. Zelensky consulted with countries already in his corner, he sat down with Narendra Modi, the prime minister of India, to make his case for support, much as he had done earlier in the week in Saudi Arabia.

☆ Zelensky Lands in Japan for G7 Summit, Seeking Military Aid
▼ + stars: | 2023-05-20 | by ( David E. Sanger | Natalia Yermak | ) www.nytimes.com time to read: +5 min

At the beginning of the war in Ukraine, President Biden told the country’s president, Volodymyr Zelensky, that he could not have American precision missile systems. Washington’s pattern of saying no before saying yes has repeated itself enough times over the past 15 months that Ukrainian officials say they now know to ignore the first answer and keep pressing. White House officials insist this reflects not indecision, but changing circumstances — and changing assumptions about the risks involved. And after China’s leader, Xi Jinping, explicitly warned late last year against threatening the use of nuclear weapons, Mr. Putin has quieted down. Some experts warn that Mr. Putin hasn’t dropped his nuclear threats; just delayed them.

President Biden told U.S. allies on Friday that he would allow Ukrainian pilots to be trained on American-made F-16 fighter jets, several U.S. officials said, adding that the president is prepared to let other countries give F-16s to Ukraine — a major upgrade of the Ukrainian military and a sharp reversal. Since Russia launched its full-scale invasion of Ukraine 15 months ago, officials in Kyiv have pleaded for advanced warplanes to overcome Russian air superiority. But Mr. Biden has resisted, concerned that the jets could be used to hit targets deep inside Russia, and prompt the Kremlin to escalate the conflict. But several European countries that belong to the NATO alliance and have F-16s in their arsenals have called for an international effort to provide the training and transfer of their jets to Ukraine. Mr. Biden told other leaders of the Group of 7 nations, the world’s wealthiest democracies, of his decision on pilot training, opening a path to supplying Ukraine with fighter jets, at their summit meeting in Hiroshima, Japan, according to several officials who requested anonymity to speak candidly about sensitive deliberations.

☆ Russia-Ukraine War Zelensky to Attend G7 Summit in Japan
▼ + stars: | 2023-05-19 | by ( David E. Sanger | Victoria Kim | ) www.nytimes.com time to read: +2 min

Image President Volodymyr Zelensky of Ukraine in Paris on Sunday. The officials did not say when Mr. Zelensky would arrive, hoping to keep details of his travels vague for security reasons. So far, there have been no public announcements about Mr. Zelensky’s plans, and the Ukrainian news media has suggested that he will join the summit virtually. If Mr. Zelensky arrives in Hiroshima, he will almost certainly have a one-on-one meeting with Mr. Biden. “We have a task to maintain the momentum of international support and communication for Ukraine,” Mr. Zelensky said in his nightly address on Thursday.

☆ Ukraine and China Will Dominate G7 Summit, but a New Threat Lurks: A.I.
▼ + stars: | 2023-05-18 | by ( David E. Sanger | ) www.nytimes.com time to read: +1 min

It is far from clear that this group of leaders — the G7 also includes Germany, Britain, France, Canada and Italy — can sustain a conversation on a technology that appeared to burst on the scene so quickly, even if it was years in the making. Past efforts to get the group to take up far more straightforward cybersecurity issues usually descended into platitudes about “public-private partnerships,” and there has never been serious discussion of rules to guide the use of offensive cyberweapons. That will enable lower-level aides to discuss details of what those first regulations would look like, the officials said. But as the G7 leaders convene starting on Friday, it will be Ukraine that will dominate the conversation, at a critical moment for Mr. Zelensky, for Ukraine and for the core Western democracies now seized with an urgent mission of bringing about what Mr. Biden calls the “strategic defeat of Russia in Ukraine.”Mr. Biden often says that Russia is already defeated. But the fear permeating the seven large democracies here is that unless the counteroffensive proves highly successful, Ukraine will settle into a bloody, frozen conflict in which the best hope would be an armistice, reminiscent of the one that brought a halt to fighting on the Korean Peninsula 70 years ago this summer.

☆ Biden Heads to Japan for the G7
▼ + stars: | 2023-05-17 | by ( Matthew Cullen | Justin Porter | ) www.nytimes.com time to read: +1 min

Biden’s trip abroad and challenge at homePresident Biden left this afternoon for Japan to attend the annual Group of 7 summit meeting, which begins tomorrow in Hiroshima. But the major potential threat to that stability this year could come from the U.S. Almost simultaneously, House Democrats pushed forward on a complex, long-shot plan to raise the limit by forcing a vote. G7 leaders will also turn their focus to Ukraine and China. “The other big issue will be how to handle China and the threat of its economic, technological and military rise.”

☆ A U.S. Experiment on Single-Payer Care Just Ended
▼ + stars: | 2023-05-15 | by ( Margot Sanger-Katz | ) www.nytimes.com time to read: +1 min

For the last three years, the United States has been operating an experiment in single-payer health care — for one disease. That era largely came to an end last week as the public health emergency for Covid-19 expired. It required insurers to pay for all Covid tests and paid testing facilities when uninsured people used them. Some people will still be able to get free Covid tests, if their insurance wants to cover them that way. If you have insurance, you can still get free Covid vaccines.

☆ What Would the G.O.P. Plan Actually Do to the Budget?
▼ + stars: | 2023-05-08 | by ( Margot Sanger-Katz | Alicia Parlapiano | ) www.nytimes.com time to read: +12 min

Budget Cuts in the G.O.P. If every agency is cut If defense, veterans’ health and border security are spared Defense Defense –18% 0% No change Veterans' medical Veterans' medical –18% 0% No change Health and Human Services Health and Human Services –18% –51% Education Education –18% –51% Housing and Urban Development Housing and Urban Development –18% –51% Homeland Security Homeland Security –18% 0% No change Justice Justice –18% –51% State State –18% –51% Transportation Transportation –18% –51% Agriculture Agriculture –18% –51% International aid International aid –18% –51% NASA NASA –18% –51% Veterans (other) Veterans (other) –18% –51% Energy Energy –18% –51% Interior Interior –18% –51% Treasury Treasury –18% –51% Labor Labor –18% –51% Social Security Administration Social Security Administration –18% –51% Commerce Commerce –18% –51% Environmental Protection Agency Environmental Protection Agency –18% –51% Corps of Engineers Corps of Engineers –18% –51% Other Other –18% –51% Source: Analysis of Congressional Budget Office data by Bobby Kogan, Center for American Progress Note: Figure shows base discretionary budget authority totals for 2024-2033. The New York TimesThe charts above show how exempting big categories of spending would make the budget caps more draconian. The budget caps aren’t the only changes in the current House bill that would reduce federal spending. tax enforcement Budget cuts would reduce tax collections, reducing the savings in the rest of the bill –$120 billion Sources: Committee for a Responsible Federal Budget ; Congressional Budget Office Note: TANF refers to the Temporary Assistance for Needy Families program.

☆ The Next Fear on A.I.: Hollywood’s Killer Robots Become the Military’s Tools
▼ + stars: | 2023-05-05 | by ( David E. Sanger | ) www.nytimes.com time to read: +1 min

But at the Pentagon and the National Security Council, there was a second agenda: arms control. If the Chinese military cannot get the chips, the theory goes, it may slow its effort to develop weapons driven by artificial intelligence. That would give the White House, and the world, time to figure out some rules for the use of artificial intelligence in sensors, missiles and cyberweapons, and ultimately to guard against some of the nightmares conjured by Hollywood — autonomous killer robots and computers that lock out their human creators. Now, the fog of fear surrounding the popular ChatGPT chatbot and other generative A.I. software has made the limiting of chips to Beijing look like just a temporary fix.

☆ U.S. and South Korea Agree to Cooperate on Nuclear Weapons
▼ + stars: | 2023-04-26 | by ( David E. Sanger | ) www.nytimes.com time to read: +1 min

WASHINGTON — The United States will give South Korea a central role for the first time in strategic planning for the use of nuclear weapons in any conflict with North Korea, in return for an agreement that Seoul will not pursue its own nuclear weapons arsenal, American officials said. The agreement, which the two sides are calling the Washington Declaration, is a centerpiece of this week’s state visit by President Yoon Suk Yeol of South Korea, who will appear with President Biden at the White House on Wednesday. The new cooperation is closely modeled on how NATO nations plan for possible nuclear conflict, but the American president will retain the sole authority to decide whether to employ a nuclear weapon. While the United States has never formally adopted a “no first use” policy, officials said such a decision would almost certainly come only after the North itself used a nuclear weapon against South Korea. On Wednesday morning, John Kirby, a spokesman for the National Security Council, said, “I would caution anyone from thinking that there was new focus on the centrality of nuclear weapons,” despite the wording of the new declaration.

☆ Inside Biden’s Renewed Promise to Protect South Korea From Nuclear Weapons
▼ + stars: | 2023-04-26 | by ( David E. Sanger | Choe Sang-Hun | ) www.nytimes.com time to read: +1 min

WASHINGTON — In the four years since President Donald J. Trump’s leader-to-leader diplomacy with Kim Jong-un of North Korea collapsed after a failed meeting in Hanoi, the North’s arsenal of nuclear weapons has expanded so fast that American and South Korean officials admit they have stopped trying to keep a precise count. North Korea’s missile tests are so frequent that they prompt more shrugs than big headlines in Seoul. So when President Biden welcomes President Yoon Suk Yeol of South Korea to the White House on Wednesday, only the second state visit of Mr. Biden’s presidency, there will be few pretenses that disarming North Korea remains a plausible goal. Instead, American officials say, Mr. Biden’s most vivid commitment to Mr. Yoon will focus on what arms control experts call “extended deterrence,” renewing a vow that America’s nuclear arsenal will be used, if necessary, to dissuade or respond to a North Korean nuclear attack on the South.

☆ What Is Mifepristone and How Is It Used?
▼ + stars: | 2023-04-21 | by ( Claire Cain Miller | Margot Sanger-Katz | ) www.nytimes.com time to read: +1 min

Mifepristone is used as part of a two-drug regimen to end a pregnancy without surgery. Along with the second drug, misoprostol, it is known as medication abortion, or “the abortion pill” in common parlance. Mifepristone blocks a hormone called progesterone that is necessary for a pregnancy to continue. Misoprostol brings on uterine contractions, causing the body to expel the pregnancy as in a miscarriage. Growing evidence from overseas suggests that abortion pills are safe even among women who do not have a doctor to advise them.

☆ Virtual Clinics Have Been a Fast-Growing Method of Abortion. That Could Change.
▼ + stars: | 2023-04-14 | by ( Claire Cain Miller | Margot Sanger-Katz | ) www.nytimes.com time to read: +1 min

A nascent but rapidly growing industry of abortion providers administers abortions only through telemedicine, with no physical clinics. A federal court ruling Wednesday that aims to ban the mailing of abortion pills could make it much harder for them to operate. Honeybee, which fills the prescriptions for most of them and is the largest mail-order pharmacy for abortion pills in the United States, said it would continue to mail the pills to the 24 states where it’s allowed. “As a licensed pharmacy, we abide by the F.D.A.’s policies and regulations,” said Jessica Nouhavandi, co-founder and president of Honeybee. Rulings in the lower courts, if they go into effect, could severely limit the availability of the drug, including allowing it to be administered only to patients in a doctor’s office.

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